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Discrete subaortic stenosis: an acquired heart disease
1Division of Cardiopulmonary Surgery, Oregon Health Sciences University, Portland 97201-3098, USA.
Summary
Discrete subaortic stenosis (DSS) involves anatomic alterations of the mitral valve and septum. Recurrence rates are high, indicating DSS is an acquired condition, not benign.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Discrete subaortic stenosis (DSS) is a significant cause of left ventricular outflow tract obstruction.
- Understanding the underlying anatomical variations is crucial for effective surgical management.
Purpose of the Study:
- To identify and characterize the specific anatomical variables within the left ventricular outflow tract in patients diagnosed with discrete subaortic stenosis.
Main Methods:
- A retrospective analysis of 36 patients operated on for discrete subaortic stenosis between 1982 and 1996.
- Surgical findings regarding the mitral valve apparatus and interventricular septum were documented.
- Follow-up data, including reoperation rates, were collected over a mean period of 7.4 years.
Main Results:
- Eighty-three percent of patients exhibited a counterclockwise rotation (60-90 degrees) of the mitral valve and septum with anterior displacement.
- Subaortic ridge resection with deep septal myectomy was the primary surgical approach.
- The 5- and 10-year reoperation-free rates were 74% and 60%, respectively, with a 27.7% reoperation rate for recurrence.
Conclusions:
- Discrete subaortic stenosis is an acquired condition resulting from pre-existing anatomical abnormalities of the mitral valve and interventricular septum.
- High recurrence rates necessitate awareness and underscore that the condition is not benign despite its name.